Can individual fatty acids be used as functional biomarkers of dairy fat consumption in relation to cardiometabolic health? A narrative review

Full-fat versus non-fat yogurt consumption improves glucose homeostasis and metabolic hormone regulation in individuals with prediabetes: A randomized-controlled trial

Dietary guidance recommends consuming low- or non-fat dairy foods for metabolic health, yet observational research indicates full-fat yogurt intake may not detrimentally affect type 2 diabetes risk. Randomized-controlled trials are needed to further explore this relationship. Our aim was to evaluate the effect of substituting full-fat (3.25%) yogurt for non-fat yogurt on type 2 diabetes risk in individuals with prediabetes. We hypothesized beneficial effects on measures of glucose homeostasis, insulin sensitivity, and metabolic hormone response following short-term consumption of 3 full-fat yogurt servings daily. Thirteen individuals completed the 8-week randomized, double-masked crossover controlled-feeding trial comprised 2, 3-week experimental diet periods in which participants consumed 3 daily servings of full-fat or non-fat yogurt; a 1-week control preceded each diet period. Following each diet period, changes in whole-body glucose handling and metabolic hormone concentrations were measured using mixed meal and oral glucose tolerance tests. Our primary outcome measure was the blood glucose concentration at the 120-minute time point during the oral glucose tolerance test. Though differences in the primary outcome measure were not observed, the full-fat yogurt diet resulted in lower concentrations of blood fructosamine, a marker of average blood glucose concentrations over 2 to 3 weeks. Further, fasting glucagon-like peptide-1 and post-prandial glucose-dependent insulinotropic polypeptide concentrations were greater following the full-fat yogurt diet. Our preliminary results indicate that short-term consumption of full-fat relative to non-fat yogurt beneficially affected aspects of glucose homeostasis and metabolic hormone regulation in individuals with prediabetes, warranting further randomized-controlled research. This trial is registered at clinicaltrials.gov (NCT03577119).

Replacement of dietary saturated with unsaturated fatty acids is associated with beneficial effects on lipidome metabolites: a secondary analysis of a randomized trial

BACKGROUND

The effects of replacing dietary saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) and/or polyunsaturated fatty acids (PUFAs) on the plasma lipidome in relation to the cardiometabolic disease (CMD) risk are poorly understood.

OBJECTIVES

We aimed to assess the impact of substituting dietary SFAs with unsaturated fatty acids (UFAs) on the plasma lipidome and examine the relationship between lipid metabolites modulated by diet and CMD risk.

METHODS

Plasma fatty acid (FA) concentrations among 16 lipid classes (within-class FAs) were measured in a subgroup from the Dietary Intervention and VAScular function (DIVAS) parallel randomized controlled trial (n = 113/195), which consisted of three 16-wk diets enriched in SFAs (target SFA:MUFA:n-6PUFA ratio = 17:11:4% total energy [TE]), MUFAs (9:19:4% TE), or a MUFA/PUFA mixture (9:13:10% TE). Similar lipidomics analyses were conducted in the European investigation into Cancer and Nutrition (EPIC)-Potsdam prospective cohort study (specific case/cohorts: n = 775/1886 for type 2 diabetes [T2D], n = 551/1671 for cardiovascular disease [CVD]). Multiple linear regression and multivariable Cox models identified within-class FAs sensitive to replacement of dietary SFA with UFA in DIVAS and their association with CMD risk in EPIC-Potsdam. Elastic-net regression models identified within-class FAs associated with changes in CMD risk markers post-DIVAS interventions.

RESULTS

DIVAS high-UFA interventions reduced plasma within-class FAs associated with a higher CVD risk in EPIC-Potsdam, especially SFA-containing glycerolipids and sphingolipids (e.g., diacylglycerol (20:0) z-score = -1.08; SE = 0.17; P value < 10^-8), whereas they increased those inversely associated with CVD risk. The results on T2D were less clear. Specific sphingolipids and phospholipids were associated with changes in markers of endothelial function and ambulatory blood pressure, whereas higher low-density lipoprotein cholesterol concentrations were characterized by higher plasma glycerolipids containing lauric and stearic acids.

CONCLUSIONS

These results suggest a mediating role of plasma lipid metabolites in the association between dietary fat and CMD risk. Future research combining interventional and observational findings will further our understanding of the role of dietary fat in CMD etiology. This trial was registered in ClinicalTrials.gov as NCT01478958.

Comparison of Milk Odd- and Branched-Chain Fatty Acids among Human, Dairy Species and Artificial Substitutes

The aim of the study was to compare odd and branched-chain fatty acids (OBCFA) of milk from sheep, goat, cow, buffalo, donkey, human, and formula milk. Ruminant, monogastric, and human milks have different concentrations of these fatty acids (FA). To highlight the differences on OBCFA, a total of 282 individual milk samples were analyzed by gas chromatography. The OBCFA were found higher in ruminant than non-ruminant milks (p < 0.05). Among ruminants, sheep milk had the highest OBCFA (4.5 g/100 g of total FAME), whereases the lowest values were found in formula milk (0.18 g/100 g of total FAME). Regarding individual linear odd-chain FA (linear-OCFA), C11:0 was found higher in donkey milk than others, while sheep and buffalo milks had the greatest concentration of C15:0. Among BCFA, the iso-BCFA were higher than anteiso-BCFA in all considered milks. The isoC17:0 showed the highest concentration in all milks except for donkey and buffalo, which showed higher concentration of isoC16:0 than others. In conclusion, ruminant milks are different in terms of these FA compared to human milk and its substitutes. However, the greatest differences were found with formula milk, suggesting that this product needs the implementation of these FA to be more similar to human milk composition.

Impact of a food-based dietary fat exchange model for replacing dietary saturated with unsaturated fatty acids in healthy men on plasma phospholipids fatty acid profiles and dietary patterns

PURPOSE

UK guidelines recommend dietary saturated fatty acids (SFAs) should not exceed 10% total energy (%TE) for cardiovascular disease prevention, with benefits observed when SFAs are replaced with unsaturated fatty acids (UFAs). This study aimed to assess the efficacy of a dietary exchange model using commercially available foods to replace SFAs with UFAs.

METHODS

Healthy men (n = 109, age 48, SD 11 year) recruited to the Reading, Imperial, Surrey, Saturated fat Cholesterol Intervention-1 (RISSCI-1) study (ClinicalTrials.Gov n°NCT03270527) followed two sequential 4-week isoenergetic moderate-fat (34%TE) diets: high-SFA (18%TE SFAs, 16%TE UFAs) and low-SFA (10%TE SFAs, 24%TE UFAs). Dietary intakes were assessed using 4-day weighed diet diaries. Nutrient intakes were analysed using paired t-tests, fasting plasma phospholipid fatty acid (PL-FA) profiles and dietary patterns were analysed using orthogonal partial least square discriminant analyses.

RESULTS

Participants exchanged 10.2%TE (SD 4.1) SFAs for 9.7%TE (SD 3.9) UFAs between the high and low-SFA diets, reaching target intakes with minimal effect on other nutrients or energy intakes. Analyses of dietary patterns confirmed successful incorporation of recommended foods from commercially available sources (e.g. dairy products, snacks, oils, and fats), without affecting participants' overall dietary intakes. Analyses of plasma PL-FAs indicated good compliance to the dietary intervention and foods of varying SFA content.

CONCLUSIONS

RISSCI-1 dietary exchange model successfully replaced dietary SFAs with UFAs in free-living healthy men using commercially available foods, and without altering their dietary patterns. Further intervention studies are required to confirm utility and feasibility of such food-based dietary fat replacement models at a population level.